Scientists show that ultraviolet (UV) light exposure leads to changes in the gut microbiome, but only in volunteers who were deficient in vitamin D.
Living at higher latitudes, which means less exposure to UV light and a greater chance of being vitamin D deficient, carries a higher risk of developing diseases such as multiple sclerosis (MS) and inflammatory bowel disease (IBD).
Research into the gut microbiome indicates that our microbial passengers may play a significant part in these conditions.
But what links vitamin D to our intestinal microbiota?
A team of researchers, many from the University of British Columbia, in Vancouver, Canada, set out to answer this question by studying how the gut microbiome responds to UV light.
When volunteers who were deficient in vitamin D received three sessions of UVB exposure, their gut microbiomes changed and bore the same hallmarks as those of study participants who were not vitamin D deficient.
The team published their findings in Frontiers in Microbiology.
UVB light boosts ‘richness’ of microbiome
The study included nine female volunteers who took vitamin D supplements in the 3 months leading up to the experiments and 12 who did not.
All participants had fair skin, specifically Fitzpatrick skin types 1 to 3.
The volunteers who had taken the supplements had vitamin D blood levels that are classed as adequate, while all but one of those who had not taken the supplements were vitamin D deficient.
All participants then had three sessions of full body exposure to UVB light. The research team saw increases in the vitamin D levels in all of the volunteers, as a result.
They then compared the composition of each participant’s gut microbiome before and after the treatments.
The authors found significant changes in the microbial compositions in the group that had been mostly vitamin D insufficient at the start of the experiment.
“Prior to UVB exposure, these women had a less diverse and balanced gut microbiome than those taking regular vitamin D supplements,” senior study author Prof. Bruce Vallance notes, summarizing the teams’ results. “UVB exposure boosted the richness and evenness of their microbiome to levels indistinguishable from the supplemented group, whose microbiome was not significantly changed.”
Specifically, the vitamin D deficient volunteers experienced an increase in Firmicutes and Proteobacteria and a decrease in Bacteroidetes, to bring their levels in line with the microbiomes of participants who had taken vitamin D supplements.
Vitamin D ‘main driver’ of shift in microbiome
Medical News Today spoke to first study author Else Bosman about the study.
“We found that vitamin D production was the main diver of the shift in the microbiome,” she explained. “It is well known that UVB light produces vitamin D, and we now start to understand that vitamin D is important to maintain a healthy gut.”
“Although those facts were known individually, this is the first study linking them up together,” Bosman continued. “The results were surprising in the way that there was a strong effect visible within 1 week’s time.”
When asked how much time we should each be spending in the sunshine to boost our vitamin D levels, Bosman urged caution.
“During the study, we made use of specialized UVB lamps that don’t cause burning. It was a therapeutically used photobooth in a clinical setting,” she explained. “From my study, it is hard to conclude how much sun exposure is enough to produce vitamin D.”
This is down to our individual skin types and the amount of UV radiation in the environment that we live in.
“Unfortunately, it is really hard to obtain enough vitamin D from diet alone, so it is wise to supplement with vitamin D during the winter,” Bosman recommended. “Your body is very efficient in making vitamin D from sunlight in the summer.”
The extent to which variations in our microbiomes resulting from fluctuating vitamin D levels affect our health is unclear at this point.
But Prof. Vallance suggests that this may be more important for people with inflammatory diseases, such as MS and IBD.
Larger studies are needed and should include the full spectrum of skin types, as well as male and female participants, the authors suggest in their paper.
“This study made use of a very selective group of participants, e.g., healthy, female, pale skin,” Bosman told MNT. “It would be very interesting to repeat the study with participants that have a lot more variety in ages and with bigger study groups to confirm the results. It would also be great if we can test if the phototherapy is useful for people with intestinal inflammation to promote their gut health.”
“The results of this study have implications for people who are undergoing UVB phototherapy and identifies a novel skin-gut axis that may contribute to the protective role of UVB light exposure in inflammatory diseases like MS and IBD.”
Prof. Bruce Vallance
Warren’s New Medicare for All Plan Is an Extremely Clever Dodge
Two weeks after Elizabeth Warren released her much-ballyhooed and Warrenishly detailed plan for how she would pay for Medicare for All, the 2020 contender released another proposal on Friday about how, as president, she would transition the country to a system under which the government provides health insurance to everyone. Like the other plans from…
Two weeks after Elizabeth Warren released her much-ballyhooed and Warrenishly detailed plan for how she would pay for Medicare for All, the 2020 contender released another proposal on Friday about how, as president, she would transition the country to a system under which the government provides health insurance to everyone. Like the other plans from the “I have a plan for that” candidate, this document was long on details and full of proposals likely to have broad support on the left. But when you zoom out from those details, it amounts to an admission that Warren won’t push for Medicare for All, and instead will embrace a more cautious path to expanding insurance coverage.
One important thing about this plan is that it is less about what Warren wants the U.S. healthcare system to look like and more about specifically what she would do as president, a level of detail that is often elided in Democratic debates. She says that she will reverse Donald Trump’s executive actions that have weakened the Affordable Care Act and use the powers of the presidency to lower drug prices by cracking down on the pharmaceutical industry. She also wants the government to manufacture generic medications, and severely limit the lobbying power of Big Pharma.
But the big question facing 2020 Democratic candidates isn’t about those kinds of policies, but how hard they would push for a government-provided health insurance system, a progressive goal since the days of FDR. Warren has said she favors Medicare for All, a position that has become controversial as debate moderators and her opponents have pressed her to admit such a massive expansion of government spending would require a tax increase. In this plan, she tweaks her stance somewhat: The bill she’ll focus on early in her administration would be a “Medicare for All Option.”
That last word matters a lot. Medicare for All is sometimes a somewhat vague phrase, but generally it means putting everyone on a single government-run health insurance system, abolishing private insurance. Warren’s Medicare for All Option wouldn’t be that disruptive. Instead of forcing everyone to buy insurance from the government, Warren would expand Medicare benefits and extend coverage to everyone younger than 18 and those making up to 200 percent of the poverty level. People who earn more than that and who are uninsured would pay premiums capped at 5 percent of their incomes.
By providing government insurance to those who want it, rather than requiring everyone to have it, this proposal seems akin to the “public option” systems favored by candidates like Joe Biden and Pete Buttigieg, though as the New York Times noted, Warren’s slate of benefits is more generous than theirs. On Friday, the Buttigieg campaign attacked Warren’s plan as an effort to “paper over” Warren’s plan to “force 150 million people off their private insurance.”
Warren says this isn’t the end goal of her healthcare policy. “No later than my third year in office,” she writes, she will push for legislation moving the country into true Medicare for All, wiping out private insurance for good. Many progressives have praised this plan, including Pramila Jayapal, the Democrat who is the chief sponsor of the House’s Medicare for All bill. But the assurance that Warren will eventually get to Medicare for All wasn’t enough for her critics on the left, who saw this as a capitulation. If you aren’t willing to fight for full Medicare for All from day one of your presidency, they argue, you have no chance of getting it.
If Warren’s plan is a dodge, it’s also an extremely logical piece of political strategy. She claims that unlike Medicare for All, she could pass her bill through a Senate process known as “reconciliation,” meaning it would require 50 votes, not 60. Furthermore, Warren supporters could argue, it’s extremely unlikely that centrist Democrats like West Virginia’s Joe Manchin and Arizona’s Kyrsten Sinema would vote for Medicare for All—meaning you might not even have 50 votes for M4A—but they might vote for a slightly less radical option.
But where this pragmatism falls apart is the idea that Warren would get to Medicare for All by year three of her term. As many people have pointed out, most presidents lose seats in Congress during midterm elections and struggle to pass big pieces of legislation late in their terms as a result. A candidate saying she’ll fight for Medicare for All in 2023 rather than 2021 sounds like your parents promising to get you a puppy two birthdays from now—in other words, just putting off a tough decision.
Not that there’s anything wrong with that. Warren’s position on healthcare is still far more ambitious than anything contemplated by the Obama administration, and she’s previously said that her highest priority will be fighting political corruption (in other words, not healthcare). A President Bernie Sanders might launch a contentious, uphill battle to try to ram through Medicare for All, but a President Warren likely will not. If that wasn’t obvious before this latest plan, it’s clear now.
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Ditch Your Phone Habits, Not Your Friendships
The label “Silicon Valley trend” is a pretty good indicator that something is going to be goofy as hell, weirdly extreme, kind of dangerous, or a heady combination of the three. Dopamine fasting is an SV-home-brewed “biohack” where people do and consume nothing for anywhere from 24 hours to a week, with the misguided aim…
The label “Silicon Valley trend” is a pretty good indicator that something is going to be goofy as hell, weirdly extreme, kind of dangerous, or a heady combination of the three. Dopamine fasting is an SV-home-brewed “biohack” where people do and consume nothing for anywhere from 24 hours to a week, with the misguided aim of “resetting” some kind of neurochemical imbalance (per VICE’s coverage, this is not really how any of this works). . But because the “fast” mostly focuses on things like technology, media consumption, substance use, and social behaviors like spending time with friends, talking to other people, or having sex, it isn’t quite as ill-advised and unhealthy as other, more restrictive tech-bro fasting practices can be. (Think: Twitter CEO Jack Dorsey’s infamous “3 day water fast.”) That doesn’t mean it’s without flaws of its own. As VICE previously reported, “making you feel good” isn’t the sole function of dopamine, and dopamine isn’t the only neurotransmitter that produces, dare I say, posi vibes. And it turns out dopamine fasting is based on a fundamental misconception about the value of social interaction that could stop fast participants from gleaning any real benefits.
According to scientists who spoke with Psych Central, a mental health website run by mental health professionals, the kind of social isolation that dopamine fasting entails could actually be detrimental to mental health. Kim Hellmans, a neuroscience researcher and professor at Carleton University, told Psych Central that interacting with other people, especially people you actually like, is actually good for you. “Humans have evolved as a highly social species, and as such, loneliness and very little social stimulation can be coded in the nervous system as a threat — since loneliness is one of the most potent stressors,” Hellmans said to Psych Central.
Yes, another earth-shattering dispatch from Big Science: Spending time with people you like is literally good for you. Studies have shown that social support from family, friends, and romantic partners has a wide range of benefits, like decreased stress levels, increased happiness, improvements in cardiovascular health, and boosts in the effectiveness of other healthy activities, like exercising regularly. Meanwhile, loneliness is on the rise, so much so that experts are working on creative solutions like meal-sharing to coax people away from their solitary habits. That’s because social isolation is absolutely a trend worth combatting: One study that found loneliness rivals smoking cigarettes when it comes to increasing mortality risk, and being lonely is way less fun than smoking cigarettes.
The element of dopamine fasting that researchers believe does have merit is the part where fasters disengage with technology. “We could all serve to ‘unplug’ every once in a while,” Hellemans said, but with a caveat: “To attribute any perceived benefits to reduced dopamine levels is an over-simplification and misrepresentation of the complexity of the nervous system.” Of course, the benefits of unplugging aren’t breaking news, either.
So: Meeting up with a friend, ditching your phones, and going for a walk outside while you have a meaningful conversation about life, love, and the ugly wedding dresses of mutual acquaintances? Awesome for your mental and physical well-being. Declining hangout invitations because you need to stay indoors, write a list of goals, and focus on not masturbating in pursuit of some questionable mental health benefits? Not so much. I think you know what to do with that information.
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Imagine Being Kicked off Your Health Insurance Two Months After Giving Birth
When Madavia Johnson gave birth to Donald Ray Dowless III last year, she was hit by a case of severe postpartum anxiety. She was scared to carry her son downstairs or drive him in a car. She couldn’t manage to continue law school―and could hardly leave the house―because she didn’t trust anyone to watch him.…
When Madavia Johnson gave birth to Donald Ray Dowless III last year, she was hit by a case of severe postpartum anxiety.
She was scared to carry her son downstairs or drive him in a car. She couldn’t manage to continue law school―and could hardly leave the house―because she didn’t trust anyone to watch him. Her weight dropped from 140 to 115 pounds.
“It was very stressful for me mentally,” said Johnson, now 29, who lives in Clayton, North Carolina. And she found it hard to secure medical assistance because her Medicaid coverage ran out just two months after her son’s birth. Public health advocates are pushing to change that.
The difficulties Johnson faced contribute to the United States’ dismal record on maternal and child health. The U.S. is one of only three countries where maternal deaths are on the rise, joining Sudan and Afghanistan, according to the Alliance for Innovation on Maternal Health, a program of the Council on Patient Safety in Women’s Health. And data from the Centers for Disease Control and Prevention indicates that about 700 women die in the U.S. every year from pregnancy complications. Sixty percent of those deaths are deemed preventable.
Democratic presidential candidates such as Senator Cory Booker of New Jersey and Senator Kamala Harris of California have talked about those problems on the campaign trail, offering sweeping proposals to address disparities that lead to poor health for many new mothers.
Though maternal and child health experts appreciate the attention to the issue, they also point to what they say is a fairly minor policy option that could make a major difference: increasing access to Medicaid for postpartum women.
“Given that we know that this crisis disproportionately falls on low-income people … Medicaid is a very smart starting place to make sure these people are getting access to needed care,” said Valarie Blake, an associate professor of law at West Virginia University who focuses on health care law.
Take Johnson, for instance. At the time of her pregnancy, she was eligible for Medicaid based on a rule that provides women who otherwise might not qualify under strict income restrictions with coverage during pregnancy and for 60 days after. She gave birth August 14, 2018.
But North Carolina has tight eligibility requirements. It is also one of the 14 states that have not chosen to expand Medicaid under the Affordable Care Act. So, by mid-October, Johnson was no longer “Medicaid eligible.” Because her physician was backed up on appointments, she lost her coverage before she had a “six-week” checkup.
Eventually, she reapplied for Medicaid and was able to qualify because her status changed since she had a child. But Donald was 8 months old before she was able to see a doctor.
Experts point to the 60-day timeline as a sort of clock ticking on some severe postpartum medical issues: bleeding, infections, breastfeeding issues, and mental health screening, among others.
“If you’re on postpartum Medicaid, you need to get those issues solved right away,” Blake said.
And that 60-day countdown? It is arbitrary, said Alison Stuebe, a professor of obstetrics and gynecology at the University of North Carolina School of Medicine. It has roots in a general idea across cultures that women need special care after giving birth, but the 60-day mark isn’t based on medicine.
“It comes from the same place as the six-week postpartum visit,” Stuebe said. “We don’t know where it comes from either.”
Stuebe chaired a task force for the American College of Obstetricians and Gynecologists that recommended a different approach. Providers should check women two weeks after giving birth, and then continue holistic care for 12 weeks, eventually transitioning the patient to primary care.
That prolonged contact is essential, she said. ”Postpartum depression, if untreated, can begin to spiral,” Stuebe said. “Even if you’re in treatment, after 60 days, you’re not better.”
Johnson, though, was left to wrestle with severe postpartum anxiety on her own.
She sought support from other new moms on Facebook who were coping with anxiety. Since her son had Medicaid for the first year of his life, his pediatrician was a source of help. She also got care through her local health department’s free clinics.
At the federal level, the idea of extending postpartum Medicaid is getting more attention. At a September House hearing, representatives from the American Medical Association, the Icahn School of Medicine, and the Kaiser Family Foundation called for expanding postpartum Medicaid to 12 months as a possible solution to the maternal mortality crisis. The American College of Obstetricians and Gynecologists has also recommended it. Booker’s bill would extend Medicaid coverage from 60 days to 12 months alongside other far-reaching proposals. (Kaiser Health News is an editorially independent program of the foundation.)
Beyond protecting women during the medically vulnerable time after they deliver, experts think increasing Medicaid could go a long way toward addressing the racial disparities that exist in maternal mortality rates. Black women are two to three times more likely to die from pregnancy-related causes than white women.
“It’s not a silver bullet,” said Jamila Taylor, the director of health care reform at The Century Foundation, a nonpartisan think tank. “There’s racism in the health care system. Coverage is a piece of that, but we need to transform the system.”
Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
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